REQUIREMENTS RELATED TO SURPRISE BILLING; PART II INTERIM FINAL RULES AND TECHNICAL GUIDANCE NO. 2021-01

Requirements Related to Surprise Billing; Part II Interim Final Rules and Technical Guidance No. 2021-01

On December 27, 2020, the Consolidated Appropriations Act, 2021 (CAA), which includes the No Surprises Act (“NSA”), was enacted. The NSA established a Federal IDR process that allows plans and insurers, and nonparticipating providers, facilities and air ambulance providers to resolve disputes regarding out-of-network payments for emergency services and certain non-emergency services.

On September 30, 2021, the federal Departments of the Treasury, Labor and Health and Human Services issued interim final rules regarding the Federal independent dispute resolution (IDR) process that the above-reference entities may use following the end of an unsuccessful open negotiation period to determine the out-of-network rate for certain services where a State All-Payer Model Agreement or specified State law does not apply.

For more information please read this detailed summary:
Requirements Related to Surprise Billing; Part II Interim Final Rules and Technical Guidance No. 2021-01

Important Open Negotiation and Independent Dispute Resolution Deadlines